Six Months in Sierra Leone

For the next six months I'll be working in the Ebola response efforts in Sierra Leone and I'll be writing about my experiences in this blog. The views and opinions expressed in this blog are solely my own and do not necessarily represent the views of any other individual, entity or organization.

Thursday, July 16, 2015

As
many of you probably know by now, I was very sick recently. I know I was pretty
sick here once before, but that doesn’t even come close to how sick I was in
the week leading up to the Fourth of July. On the Sunday night prior to the
Fourth, I told Meredith that I wished we could just have one extra day of the
weekend so I could lay around being my typical lazy self. The next day, as I
lay on the couch feeling ill, I really regretted saying that. While I felt
pretty sick that Monday, it was definitely a sickness that seemed like a
passing bug. On Tuesday morning I still felt a little queasy, but I felt well
enough to go to work. I had more to do that week than I’d had to do in a while
and was supposed to be doing something specifically for our Country Rep (CR) so
I wanted to get back to work right away. Within an hour of getting to the
office I started feeling really warm so I pulled out my thermometer and my
temperature was 99.1 F. That doesn’t seem like too much to worry about, but the
safety policies for Ebola require you to leave the office immediately if your
temperature rises above 98.6 F at all. So I ran to Sasha’s office and told him
I had a fever which he was not pleased to hear. He asked me a bunch of
questions about other symptoms and then told me to get a driver to take me
home. Obviously we hit a ton of traffic on the way home so it took us almost an
hour to get home and by the time we did, I felt like I was going to die. I
literally almost collapsed as I was walking into the house. I made a beeline
for the couch and collapsed onto it. I knew I should get up and change out of
my work clothes and get medicine and something to drink, but I couldn’t bring
myself to get up so instead of doing that I did what every adult does when
they’re sick – I called my parents. I felt too weak to even hold the phone so I
just alternated between calling my dad and my mom and kept them on speaker
phone as I proceeded to writhe around in pain and misery on the couch.
Thankfully Meredith was coming home for lunch that day for a Skype interview so
I texted her to ask her to bring me home some Gatorade and/or Coke. My fever
was probably up to about 101 F by the time she got home and I was so out of
it. She was kind enough to get me drinks and a cold, wet cloth for my face and
anything else I needed. Then Sasha called and when he found out my temperature
had gone up more he told me he was coming home right away to give me a rapid
test for malaria. Soon after Sasha arrived at home he gave me the malaria test.
Waiting for the results was the longest 15 minutes of my life. Before he gave
me the test, Sasha had said, “If it’s negative then I would be concerned.”
Having had malaria is something of a badge of honor in the public health world,
but that's definitely an honor I can live without. But
when Sasha told me that we should be worried if it’s negative, I was seriously
praying that it was malaria. Obviously there are a lot of other things that can
cause a fever, but my symptoms and their progression coupled with the fact that
I had been in the field the previous week and we’re in Sierra Leone and we’ve
been seeing a spike in cases, put Ebola at the forefront of our minds. Quite
frankly, in hindsight, it was freaking terrifying. Thankfully, at the time, I was so out of
it that I couldn’t quite comprehend just how terrifying things would become if
I did in fact have Ebola. I was oddly calm. When the malaria test was negative, I basically
thought, “Okay. I have Ebola. I could die. That’s okay.” I felt so horrendous
that I didn’t even really care at that point. I remember Sasha standing over me
at one point and saying, “You’re miserable, huh?” I just looked at him and
nodded. Somewhere in that time frame I Skyped with Anna Marie and EJ so they
could pray with me. I don’t really remember much of our conversation, but I’m
grateful that they were willing to take time to talk to me. After the malaria
test came back negative, I was about ready to call for a plane to medevac me
back to the US, but obviously that wasn’t something that was really going to
happen unless Ebola was actually confirmed and that wasn’t an option. In order
to confirm Ebola, a team would have had to come to Sasha’s house in full PPE to
collect a sample from me and given my symptoms, I would have ended up in
quarantine in a holding unit in a Sierra Leonean hospital until it was
determined I didn’t have Ebola. That is not a situation that you ever want to
be in. So instead of jumping to the outlandish conclusions that were running
rampant in my head, Sasha said that we would treat my symptoms and hope that
they resolved. I took Paracetamol to reduce my fever, but my temperature just
kept going up. As far as I know, my temperature peaked just shy of 103 F, but
it could have gone higher while I was passed out on the couch. After sleeping
for a few hours, I woke up to find Sasha and Annisha at the dining room table
alternating between doing work and staring at me. My temperature was about 102
F then, but I didn’t feel hot anymore because I’d gotten used to it. I was able
to get off the couch for the first time and Sasha forced me to drink ORS
(although I didn’t actually drink very much of it because it was disgusting)
and eat some soup. Eventually, after a couple of doses of Paracetemol, my fever
slowly started to go down. It was still well over 98.6 F for a few more hours,
but it went back to normal after about twelve hours or so. Over the next few
days, my temperature remained normal, but I still had plenty of other symptoms
and I was unbelievably tired so I ended up spending the entire week at home. I
probably could’ve gone to the office on Friday, but Sasha was working from home
so I just stayed home too. I think I probably had a bad case of food poisoning,
but I don’t know how I got it. I’m so grateful that Sasha and Meredith chose to
ignore the rules that tell us not to get near someone who has even the
slightest chance of having Ebola in order to take care of me. Even though I
didn’t have Ebola (thankfully), I got a brief glimpse into what it might be like
for people who are suspected of having Ebola. I know that what I experienced
was nothing compared to what Ebola patients endure so the whole thing motivated
me to finish out my last few weeks here in Sierra Leone with renewed vigor and
optimism so that we can end this outbreak once and for all. ﻿

I've never been happier to see 98.6 F on a thermometer

After
combating my illness, I decided to join Sasha and Meredith and go to Martin’s
place at Black Johnson
Beach for the Fourth of July. I hadn’t been to Martin’s since my very first
weekend in Sierra Leone back in February, but Martin has visited us in Freetown
a few times. He’s weirded me out ever since I met him, but his creepiness
factor has gotten significantly higher since I discovered that he’s recently
taken on a Sierra Leonean wife who cannot possibly be more than 22 years old
and she’s probably even younger than that. Martin is at least 45 years old. Don’t
get me wrong – Martin is a nice guy and he’s got some incredible travel stories
and we bonded over our shared love of astronomy, but this whole situation with
his young bride makes me extremely uncomfortable. I was, however, comforted by
the fact that Meredith and Annisha also find it to be really strange. His wife,
Effie, is very quiet around us so it’s hard to know what she’s really like when
it’s just the two of them. This type of situation is quite common in Sierra Leone,
but it begs the question – what motivates a middle aged European man who’s
traveled all around the world to come settle in Sierra Leone and take a “bush
wife” (as Meredith puts it) and why does he make such awkward comments about
the situation? But it’s really none of my business. There is one really
interesting thing that was happening on the Monday after we left. They were
going to have a traditional fertility ceremony. It involved slaughtering a
chicken and Effie’s grandmother coming to perform a ceremony where she would
rub oils of some sort on Effie and pray that she would get pregnant. Martin
doesn’t really seem like the father type to me (considering the fact that he
thinks he probably has multiple children around the world and has no desire to
find any of them…), but again it’s none of my business. I can still think it’s
very strange though. Anyway, apart from all that the Fourth was not very
exciting. We did, however, have this delightful “Product of USA” to eat and I
may or may not have opened the can, ate a few and declared, much to Meredith’s
amusement, “Tastes like freedom.”

Sasha
didn’t get us any fireworks (literally the one thing we wanted for the weekend)
so we ended up going to bed by like 9pm and it was insanely hot and humid so it
was really hard to sleep. We spent the next day just lounging around on the
beach and hoping it would get a little sunny which it finally did. Then I had the
joy of sitting under a thatched umbrella while it drizzled all around me and it
was literally perfect. Overall, it wasn’t how I would prefer to spend my Fourth
of July weekend (it’s amazing how patriotic you can become when doing anything
patriotic isn’t really an option), but it was pretty nice...

View on the way out of Freetown...I'm really going to miss this :-(

The hangout at Martin's

This sky made up for the fact that we didn't have any fireworks

Donal
also arrived in Freetown recently. I’m not entirely sure what Donal’s job is, but he’s
Irish and he’s hilarious and that’s all that really matters. He arrived on the
day I was really sick and he came to Sasha’s for dinner the following evening.
I was still feeling quite sick and he was very drunk by the time I managed to
muster up enough energy to talk to him (whilst in my pajamas which wasn’t
awkward at all…). I had been in my room, but I heard Meredith trying to explain
the Electoral College system to Sasha and Donal so I felt the need to drag
myself out of bed to complain about what a horrendous system it is (although I
also feel that the alternative system of a straight popular vote is bad too so
I can’t win) and that obviously incited a political discussion in which Donal incorrectly
assumed I’d be voting for Hillary and was shocked to find a Republican working
for CRS. I am literally dumbfounded by the lack of conservatives in this
organization. It’s a faith based organization. You think there’d be a few
conservatives. I have yet to find one though. It’s well known that public
health is dominated by liberals so I guess I shouldn’t be that surprised.
Anyway, the point is that Donal was so shocked that he asked where I was from
and obviously when I said I was from Rhode Island he was even more shocked, but
since he was super drunk things got off topic very quickly and he started
talking about the delinquent Boston Irish who, according to him, are not real
Irish people. It was pretty funny. Fast forward to last Wednesday night in
which another, less friendly political conversation occurred. Sasha and Meredith
volunteered to host Wednesday night dinner and we finally did pizza night!! It
was fantastic. Domenic is such an awesome chef. He’s been in charge of cooking
for two of the Wednesday night dinners that I’ve been to and he has done a
great job both times. He apparently worked in a pizza shop in Sweden at one
point so he knew exactly what he was doing. He made about 20 different pizzas,
one of which had a fried egg on it which made me ecstatic. When I wasn’t
hovering around the kitchen trying to grab a piece of pizza before it
disappeared, I was sitting outside on the porch with a small group of people
just relaxing and avoiding having to talk to a million people I don’t know.
Towards the end of the night, I was sitting outside with Pat and his wife,
Hawa, and an older gentleman named Roger. I was already annoyed with Pat
because he had told me he hates the Queen. I can’t even comprehend that. While
I’d not so secretly prefer that we have a monarchy and that we still live like the Crawley’s do
in Downton Abbey, Pat is quite the socialist just like Tom on Downton. Anyway,
he decided that he felt the need to tell me that I should be a democrat because
I’m a woman from New England and that Bill Clinton was the best president we’ve
had since Kennedy. His wife was trying to get him to calm down and stop being
an idiot, but he wasn’t having it. Then Roger started telling a story about
what English and Irish relations were like when he was growing up and how the
Irish were always looked down on by the English. In the middle of the story he
mentioned that they used to call the Irish “Paddies”. Well, Pat flipped out on
Roger and started yelling at him and saying that he was being rude and he wasn’t
going to sit there and let him call him that name. He told Roger not to be rude
and poor Roger was saying how he didn’t mean anything by it. I refuse to let
anyone insult the elderly so I told Pat that he was the one being rude and he
got up and stormed away. Hawa chased after him and I sat with Roger who was
clearly very unsettled and shaken up by the whole thing. Later after Pat and
Hawa had left, I was talking with Roger and he said that Pat should have known
better than to talk to him like that, but he said, “Then again, he’s Irish…” I
guess that British/Irish relationship still isn’t great.

Last
Friday night I went to dinner at Lagoonda with Annisha and Meredith. It was
delicious as usual. On the way home Meredith and I saw a guy completely ignore
a “Road Closed” sign and just drive straight on up a hill that they’ve been
doing construction on for ages. This is pretty typical in Sierra Leone, but
Meredith was like, “Rule of law? Who needs it?!” I nearly died laughing. It’d
probably be funnier to you if you lived here. Anyway, in other random funny
quote news, Annisha was talking about questions that Meredith might get asked
in her interview and as the questions got progressively more ridiculous and
funny, Annisha says, “Tell us about a time when you tried to save the world
with no resources.” This is also probably funnier if you’ve actually worked in a
country like Sierra Leone or a situation like the Ebola response. The (not at
all funny) point is that we never have enough resources. I was shocked when I
first found out how much money we spend in a week for just one project. We are
spending millions of dollars to help people in ONE district of ONE country. I
certainly believe that ever person matters and that everyone deserves to live
at a certain standard, but when you think about how much money must be spent
all around the world on projects like this, it’s overwhelming. Sometimes it seems so futile, but when you think about the individual that you're helping, it makes it a little better knowing that your project is making a difference in their life. Last
Saturday we had a delightfully American brunch. Sasha thought it was so disturbing
that Meredith and I like syrup on our bacon and eggs. Clearly he doesn’t know
what he’s talking about. The rest of last weekend was pretty uneventful. I met
one of our new TDY-ers, Michelle. She’s from California and she’s pretty cool. Sasha
and I watched tennis (after having worked from home on Friday just so we could
watch the men’s semifinals) and were disappointed that Federer lost.

Anyway,
this week hasn’t been too bad. Eve left which is sad. Annisha has been coming over after work most
days because her boyfriend, Ahmed, is in Kenema for a week or so at the school he runs there. We’ve had some tasty food including Annisha's naan. I was also asked if I wanted a contract with CRS
and I’ve been avoiding giving them an answer because I’m going to be really
awkward when I say no. While I’m so glad to have had this opportunity and I’ve
enjoyed working for CRS, I think it’s time to move on. Anyway, Sasha wasn’t
feeling well today so we worked from home. Actually, I worked and Sasha slept. I
was more productive today than I’ve been all week at the office. Tomorrow is
the end of Ramadan so it’s a public holiday which is fantastic. I don’t think
there’s anything better than getting a day off for a holiday you don’t even
celebrate. Typically Freetown is like one big party during this holiday (Eid
al-Fitr), but it will be interesting to see what it’s like tomorrow given the
Ebola situation. What exactly is the Ebola situation right now? It’s not good.
In recent weeks we’ve seen a spike in cases in Port Loko, Kambia and Western
Area Urban (aka Freetown). In Port Loko the cases are confined to two chiefdoms
and Operation Northern Push is hopefully working to stop the spread there, but
the sudden, fairly large increase in cases in Freetown was unexpected given
that we had gone 18 days without a new case here. I attended the Ebola
Frontline meeting at UNDP this week and, after getting over the shock of the
facilitator opening this high level meeting by having us mediate (clearly Ebola
has made people a little crazy), I learned that we should be expecting even
more cases. That’s not exactly surprising, but it’s a bit depressing. In
addition to the increase in cases here, Liberia reported new cases after having
been declared Ebola free back in May. That was devastating, but it’s reassuring
that they seem to have things under control and were able to catch things
quickly using their surveillance system. Sasha and Annisha are absolutely
convinced that Ebola will never end here. I have my moments where I start to
agree with them, but those pass pretty quickly. Nothing’s impossible. Ebola
will end here. After it ends, it will likely come back again eventually, but
stopping the current outbreak will be a huge achievement and when the next
cases develop people will know what to do.

Thursday, July 02, 2015

Operation Northern Push has officially
begun. This surge effort focuses on the two districts – Port Loko and Kambia –
that were responsible for the large increase in cases we saw a few weeks ago.
These two districts are basically on lockdown for 21 days (which we're almost past at this point because I've procrastinated on posting this for so long) and surveillance
activities have been increased. We’ve brought in a bunch of new vehicles to
deal with the surge and our burial teams are working harder than ever. Putting
so many restrictions on movement in these two districts also means that food
needs to be supplied to them which adds additional strain. It’s also started to
rain a lot more so that’s bringing additional problems as well. Malaria cases
will rise which is problematic because malaria looks similar to Ebola
initially. The rains have also caused a lot of devastation. In addition to
wiping out many of the roads we use to travel into more remote chiefdoms, the
rains have also destroyed hundreds of houses across the country. The rainy season is at its’ worst in July so who knows what will happen over the next few weeks. It will be interesting to see
what happens with this surge effort. It’s now official that the outbreak will
not be over before I leave Sierra Leone. I can’t believe I leave Sierra Leone
in less than 42 days!! Actually, I leave one month from today!! Even though I won’t be in the country (although I've been asked if I would come back so maybe I will be...) to celebrate the
end of the outbreak, I hope that this surge helps to bring us closer to beating
Ebola and that the country can be declared Ebola free soon after I leave.

View of Freetown from the office

In other news, the President recently
announced that stores can stay open until 9pm and restaurants can stay open
until 10pm and be open on Sundays!! This doesn’t apply to the two districts
involved in Operation Northern Push, but it’s still exciting. Although I think
it had more to do with Ramadan than anything else. As I’m sure you all know,
Ramadan is a Muslim holiday that involves, among other things, fasting from
sunrise to sunset. The sun sets after 6pm so if restaurants and stores had
remained closed after that time, people would have been unable to go out to eat
or to purchase food. While Ramadan and the related food issue has, in my opinion,
been the motivating factor behind the joyful ending of the business curfew, it
has also brought some very difficult challenges. As I mentioned, Ramadan
involves fasting. This includes refraining from both food and liquids. For
burial and ambulance teams working in PPE this is a serious issue. While
wearing PPE, you lose a TON of fluids because the suits are incredibly hot.
Even people just standing around in them sweat profusely. In a predominantly
Muslim country, how exactly do you deal with Ramadan during Ebola? You tell
people not to fast, of course. That was the general consensus at the most
recent burial pillar meeting. There are exceptions to fasting on Ramadan, but
after a quick perusal of Wikipedia, it doesn’t seem that any of those
exceptions include “because you’re wearing PPE during an Ebola outbreak.” I’m
not specifically involved in this process, but the plan has been to work with
Muslim leaders to get them to make an announcement saying that those involved
in the response who have to wear PPE are exempt from the fasting requirement.
I’m not sure if this has happened yet though. At the very least, we are asking
teams to voluntarily refrain from fasting. If they are unwilling to do that, we
are asking that they at least drink lots of water during the day. If they
refuse that suggestion then I don’t know what the plan is because obviously we
aren’t going to fire them. We considered having them switch places with someone
who doesn’t observe Ramadan and who doesn’t wear PPE, but this is problematic
because only certain people are trained to do certain tasks and, in reality, everyone
on these teams wears PPE at some point in the process. Despite all this, I
found out that there’s a public holiday when Ramadan ends so it’s all good
because I get an unexpected day off a month from now!! But seriously, pray for
our teams and everyone wearing PPE during this time because apart from the
typical Ebola related concerns, there are now even more health concerns
involved in their job.

It’s been awhile so here's a quick aside about some random
things that have happened recently. One day one of the main stories on the radio was about the
President going to Germany to receive his annual physical which he apparently
missed last year because of Ebola. First of all, I think it’s outrageous that
the President goes to a European country to go to the doctors when people here
can barely access medical care at all. Also, can you imagine if CNN had a
breaking news report every year when the President went for his yearly
physical? Anyways, I also saw a dead motorcyclist in the middle of the street.
There were huge crowds gathered around the poor guy as we drove by the scene.
His body had already been placed in a body bag which is not acceptable because
only burial teams are supposed to do that. On a totally unrelated note, I learned one rainy season lesson
the hard way...don’t let the cleaning lady wash three of your four pairs of work
pants on the same day because they will be wet for the next three days and
you’ll have to wear the same pair of pants every day. Thankfully pants never
get dirty, right? My former supervisor, Nancy, left on the 14th and Davor is my
new supervisor. We went to Country Lodge for dinner on the Friday night before
Nancy left and on the way we saw someone washing his clothes in the water that
was streaming through the gutter. Meredith took one look at him and said,
“Doesn’t he know there’s a river right there?” It was pretty funny, but I guess
using rainwater is much safer than getting in a river that’s got all types of
parasites in it. I’ve become the sole representative for CRS at the weekly
Burial Pillar meetings at the NERC. The meetings have become very interesting
lately. We began discussing the possibility of transferring responsibilities
for burials to funeral homes. A burial team would still pick up the body, but more
traditional funeral practices could begin again. This was done very
successfully in Liberia, but Liberia is not Sierra Leone. While Sierra Leone is
about 75% Muslim, Liberia is about 85% Christian. Muslims do not use the
funeral homes so it is only Christians that would benefit from this new plan.
This helped in Liberia because it’s predominantly Christian. Since Sierra Leone
is predominantly Muslim, this plan is unlikely to benefit significant numbers
of people. Either way, we don’t think we’re quite ready to make the transition
to using funeral homes just yet. Personally, I think it’s unlikely to happen at
all.

"Nor Pis Ya Dortyman" sign near the office

I was in the field last Wednesday,
but on the previous Wednesday we went to Martin’s for the weekly Wednesday
night dinner party. The theme was Latino Night which wasn’t really my favorite.
I’m dying for pizza night. I did meet a lot of cool people including a couple –
Helen and Peter – from the Netherlands. Helen has given me some helpful
hints about non-touristy things to do while I’m in Amsterdam in August. I also
met an older couple – John and Mary – who are from New Zealand, but who have
lived all over the world since 1995. John works for the brewing company here.
They only just arrived, but they’re so used to adjusting that they can find the
positive in just about anything. I loved hearing all of their stories about
their time in Thailand, Myanmar, the Netherlands, South Africa and Nigeria.
Their kids moved with them when they were younger, but they were living in
Papua New Guinea when the kids started finishing started finishing primary
school and apparently everyone in Papua New Guinea goes to Australia for
boarding school when they get to secondary school age. John and Mary’s kids
ended up going back to New Zealand for boarding school, but got to visit their
parents wherever they happened to be a few times each year during school
vacations. It was really fascinating to hear all about it. On the way home we
came across a roadblock. I’m not usually out late enough to experience these in
Freetown, but when I am, we usually just pass right through. Not this time. The
police officer stopped us and shined his flashlight in our faces and started
asking Sasha for money. Once his partner heard what he was doing, he walked away and then things started to get a little tense. I was getting
a bit nervous, but several minutes later we drove away safely and without
surrendering any money.

Last week I went up to Makeni for a few
days. Davor and I went up together and we stopped in Port Loko for a little
while on the way up. The Command Center in Port Loko is a completely different
place than it was just a few weeks ago. With Operation Northern Push heating
up, there are a lot more British military personnel (they had left a while ago,
but they’re back now) and there are tents sent up everywhere. There’s a lot
more going on and hopefully the effort will help bring the case numbers down.
When we finally arrived at the hotel in Makeni, Davor and I walked in and
Elijah, one of my favorite Mena Hills staff members, said hi and then asked,
“Do you still want this room?” He was pointing to Room 6 and Davor said, “Yeah,
yeah that’s fine.” What Davor didn’t realize is that Room 6 is my room. It’s my
favorite room and the staff members know that so when I come they make sure to
reserve that room for me. Anyway, when Davor replied, Elijah just laughed and
said, “No, No. I’m talking to her.” It’s the little things. Unfortunately,
things haven’t been going very well at Mena Hills. John B., one of our favorite
employees, was fired because “he was messing with the money.” Now some people
may think that he deserved to be fired, but there’s always two sides to the
story. At most, John B. took a couple of Cokes and a little money. Everyone
here does stuff like that. Just because everyone does it, doesn’t make it okay,
but there are other things to consider. John B. is an orphan. He has been
raised by the pastor who owns Mena Hills since he was a very small boy. I’m
sure the pastor knows that everyone takes some (“small small”) money here and
there. John B. just happened to be the one who got caught. The pastor wasn’t
making much of a profit so he started looking into things and this is when John
B. got caught. The pastor told some of our staff that he “wanted to make some
money during Ebola” so he needed to make an example out of John B. That doesn’t
seem like the way the pastor should be treating a boy he raised as his own and
it was very disheartening for us to hear that his main motivating factor was
money. Being the awesome people that they are, our staff members who stay at
Mena Hills have tried to help John B. out by giving him some money here and
there and there was even talk of hiring him as a messenger for CRS. I’m not
sure if that happened, but I hope it does or that the pastor reconsiders and
rehires John B. because he’s really a standup guy. I also finally got to go
with John (our staff member, not John B.) on his nightly walk. Every single
night he walks around Makeni for about an hour. As we were walking, everybody
was waving to him and inviting him to come dance or have palm wine with them.
That’s the type of thing that makes being in the field way better than being in
Freetown. John returned to Sri Lanka permanently this week and I was extremely
sad to see him go. When I first arrived, Annisha always told me that John
reminded her of her dad and I can see why she’d think of him as a father
figure. He was always looking out for us. The first time I went to the field,
he was the one making sure that I stayed far away from the burial team members
and gravediggers, asking the staff to get me a mosquito net when my room didn’t
have one and ordering food for me when I didn’t know what to ask for from the
staff at Mena Hills. I think John is the type of person every CRS employee, or
every person in general for that matter, should strive to emulate. I look
forward to seeing him again when I travel to Sri Lanka someday.

View over Freetown from Hill Station on our way to Makeni #lookingood #rainyseason

UNICEF tent set up outside the Port Loko CCC for Operation Northern Push

One of my favorite things that happens
here involves crossing the street. The streets of Freetown are insane. Okada (motorbike)
drivers ignore all the rules (okay, there aren’t actually that many rules here,
but they certainly ignore common sense), much like obnoxious cyclists do in the
US. There are no stop signs or traffic lights. It’s basically pure madness.
There are also tons of little kids on the streets. Unlike in the US where
people have gotten arrested for allowing their kids to walk to school alone,
kids here are pretty much always walking by themselves. One thing I’ve seen
that I absolutely love is little kids crossing the street. If they’re still
pretty young, they sometimes get nervous about crossing the street
because of all the crazy drivers. When this happens, they will look around with
a look that screams “Help me” and a random adult will take their hand, stop
traffic and take them across the street. In the US, kids are taught not to talk
to strangers, but in Sierra Leone, everyone is like family. As I traveled back
from Makeni last week, one of the most outgoing and friendly national staff
members, Aminata, traveled back with me. While we were in the car, we stopped
at a bunch of different points along the way to buy fruit and whatever else
Aminata needed. At one particular stop, everyone was calling her “Aunty” (the
term of respect people use here) and trying to get her to buy from them and
when we pulled away she was just laughing and asking me if I’d ever seen
anything like this. We soon drove by a group of school kids who were walking home
and they all started waving and saying hi and I mentioned how much I love when
they do that because that’s not typical in the US. Aminata told me that she had
taken her son to NYC last year and when they were there she had to tell him, “Don’t
do what you’ve been doing in Sierra Leone. Don’t say hi to everyone. Don’t open
the door for everyone.” How sad is that? It would be so nice if we could say hi
to everyone on the street with being looked at as if we had four heads or if children could open the door for every person who knocked and invite them in
without having any reason to be afraid. Sierra Leone has us beat there. On a
different note, every time I travel with Aminata we seem to be transporting
something outrageous. Note to self: don’t look at what we’re transporting when
we drive back from Makeni. Last time I came face to face with a live chicken
and this time I ended up sticking my face in a box of cows feet which is really
a misnomer because the feet were still attached to what appeared to be a
recently severed cows leg. Lesson learned.

Sunday, June 07, 2015

Before
I get to the real point of this post, let me share a few brief updates about everyday events that have occurred recently and which might be of some interest to you.

1.My
colleagues are getting malaria left and right. It wasn't entirely surprising to me
when I started hearing about national staff members getting malaria. The rainy
season has started so there are more mosquitoes and national staff members
obviously don’t take malaria pills. At least one of them has admitted to me
that he doesn’t sleep under a mosquito net either. And I’m sure it’s the same
for other people. To be honest, although I loved my mosquito net in Kenya
because it felt like my own little personal bubble of safety from both
mosquitos and tons of other nasty insects, I hate my bed net here and I’m
starting to understand why people don’t use them. They are such a pain to have
to tuck in every single night. And when I’m in the field, they usually aren’t
even big enough to tuck under the mattress so I just have to rest the edges on
the bed and hope no mosquitos get inside. Anyway, now international staff are
also starting to get malaria. The primary reason is, of course, that they aren’t
taking malaria pills. Taking malaria pills every day isn’t sustainable when you’ve
been here for three years, but even staff who have been here for less than a
year have stopped taking them and always seemed shocked when I tell them that I’m
still taking mine. In Kenya, knowing it was winter and that malaria wasn’t even
endemic there, I think just about everyone, myself included, stopped taking
malaria pills. Here in Sierra Leone, that would be a very bad idea. If I step
out onto the veranda in the evenings, I inevitably return inside with a slew of
welts all over my arms and legs and sometimes even on my face. Not being one to
use bug spray, I will continue to take my malaria pills until I leave and begrudgingly
use my bed net every night. I should also probably learn to stay inside around
sunset.

2.I
can’t remember if I’ve already written about this, but there’s a horrific story
coming out of Guinea about the transport of a person who died from Ebola.
Apparently, wanting to bury this man in the traditional (unsafe) way, the
victims’ family dressed him up, propped him up in the backseat of the car and
drove him back to his village to be buried. It’s literally like something you’d
see in a movie. Needless to say, the family members who assisted in this
ludicrous endeavor all got Ebola. Additionally, it was near the Guinea-Sierra
Leone border so I’m sure this is contributing to the spike in cases we’ve been
seeing in Kambia (a district along the border with Guinea) and Port Loko (south
of Kambia and on the main highway between Freetown and Conakry). I wish we
could just shut down the entire border with Guinea. Unfortunately, it’s even
more difficult to successfully patrol the border here than it is in the US.

3.We’ve
rented office space at Caritas Makeni because there are just too many of us to
comfortably fit into the office in the Command Center. So all of the finance
people have moved over to the Caritas Office. I’ve been to Caritas Makeni
before, but I hadn’t yet seen our office space so on Thursday afternoon, Jethro
and I got a driver to take us over there so we could visit John. When we
decided to leave, however, we called Yayah only to discover that there was no
car available to pick us up right then. So Jethro suggested we walk back to the
Command Center. It really isn’t very far, but it was hot and I was wearing
jeans so I wasn’t completely enthused by the idea. But we walked back anyway
and I took the opportunity to be a tourist outside the Command Center.

Now I want to share something that has
greatly affected me this past week. I was in the field from Wednesday-Friday.
As you know by now, I love going into the field more than anything, especially
when I get to go to Makeni. I enjoy chatting with John and Jethro over dinner
and learning more about the staff at Mena Hills, the hotel we stay at there.
Well, this past week, we were at dinner and I was eating the usual chicken and
chips (fries), but I couldn’t finish everything. I left some half eaten chicken
still on the bone and a handful of chips that I’d put my hands all over while I
was eating. I put my napkin on top of the food that was left to indicate that I
was finished and that the girls who work there could take my plate away. When
John saw me do this, he said, “No, no. Put your napkin here,” while pointing to
a spot off my plate. I looked up at him, thinking to myself, “Okay, but does it
really matter where I put my napkin?” I soon realized it did matter. John told
me that the Mena Hills staff will happily eat what was left in my plate. It
seems so obvious now – why should they let that food go to waste? But when John
said it to me, it kind of surprised me. I mean, these weren’t leftovers. They
were scraps. They were literally half
eaten scraps that I’d put my hands and mouth all over. In the US, restaurants
can’t serve food to someone else if it’s sent back without even being touched.
What’s even more upsetting is that the workers at Mena Hills are probably some
of the most well off people in Makeni. They have jobs, they get their school
fees paid for by the owner (and some of them are even in college now) and they
get to shower somewhere out behind the hotel rather than washing in the river.
So if they’re eating my scraps, what is everyone else doing?

Tuesday, June 02, 2015

Today I am exactly 2/3 of the way through
my 6 months in Sierra Leone!! In light of this, I thought some reflections were in
order. This is really just an update about the current situation and a random
assortment of thoughts I’ve had about my time here. I’ve been very busy lately
analyzing burial data. I’ve created a database of about 7,000 burials and it
just keeps growing. I’ve gotten quite sick of it. But yesterday I gained a newfound
appreciation for the task. Like I said, I’ve been spending quite a bit of time
cleaning, sorting and analyzing all this burial data. Going through a list of
7,000 burials to ensure the data entry people have entered everything properly
is a bit tedious and since a lot of the data was NOT entered correctly, I’ve
had to go back and make changes. Until yesterday I was rather annoyed by this
because I’m so sick of looking at spreadsheets. But then I realized something.
Apart from in the hearts and minds of their family and friends, this database
is where all these people who have died are being remembered. And I’m in charge
of it. It sort of makes me feel like The Giver (if you haven't read that book, do it now). When I realized that I was a bit taken aback. I’d never really thought
of it that way before. But these people mattered. Whether they died from Ebola
or something else, they shouldn’t be forgotten and the least I can do is make
sure their name, age, sex, date of death and the location of their grave are entered properly
in this database so that it’s always searchable. It’s easy to start getting
lazy about how things are entered and whether every single little detail is
correct when you have so much data to sort through so realizing how important
this actually is to honoring those who have died has really reinvigorated me.

My supervisor is leaving on June 14th
and that means that I am probably going to be working harder than ever from then
until I leave in August. Davor will be taking over for my supervisor
temporarily, but I’m being tasked with a lot of her responsibilities such as
attending weekly burial pillar meetings as the only CRS representative and
probably managing a few other staff members. I attended the burial pillar meeting
at the NERC today and learned a lot about where things stand right now. First
and foremost, there are approximately 250 quarantine escapees from Guinea whose
whereabouts are unknown. They have most likely crossed into Sierra Leone and
will probably cause issues for us. Also, there are secret (unsafe) burials
taking place in funeral homes when the relatives of the deceased can afford to
pay 1.5 – 4 million Leones (~$340 - $900) to make it happen. Most people can’t
afford this, but it is definitely happening among more well off families. Now
there is some talk of following Liberia’s lead and getting the funeral homes
involved in the solution by training them on how to conduct safe and dignified
burials and swabbing so that they are able to safely prepare bodies and
families will be able to have a more traditional funeral for their loved ones. Typically
burials teams collect the body and take it straight to the cemetery to bury it.
If funeral homes get involved, there can be a more proper ceremony instead of
just doing something at the graveside.

The rainy season has started to pick up
even more. Last night we had the most intense storm I have ever been in. The
thunder literally sounded like there was a gunshot right next to my ear. It’s
helped to cool things down a ton and that is fantastic! I got to go back to the
field again last week. I hadn’t been in two weeks and I think that was really
making me miserable because being stuck in the office in Freetown is no fun.
All of my colleagues that are based in Makeni were back from R&R and it was
such a fun trip even though I didn’t get to come back to Freetown until
Saturday. I wasn’t thrilled about having to lose a good portion of the day
traveling, but at least I got to get out of the office for the two days before
that.

The staff at the hotel in Makeni decided to put the chickens in the pool for safekeeping

Last week I realized that by the time I
leave here in August, I will have spent 8 of the last 13 months in Africa. Last
summer I was working with the Maasai in Kenya and waking up to views of
Kilimanjaro every morning. Now I’m in Sierra Leone fighting Ebola and enjoying
nonstop ocean views. No matter how stressful this job is, my life is really good. Not
just right now, but always. I’ve almost always gotten the big things I wanted. I’ve had
endless opportunity in my life. There’s
a song by Matthew West called “My Own Little World” and the lyrics always make
me think, but being here in Sierra Leone, they seem to be even more poignant.
I’ll post a link to the video at the end of this post, but the song starts like
this…

In my own little world it hardly ever rains
I've never gone hungry, always felt safe
I got some money in my pocket, shoes on my feet
In my own little world
Population: Me

I try to stay awake during Sunday morning church
I throw a twenty in the plate but I never give till it hurts
And I turn off the news when I don't like what I see
Yeah it's easy to do when it's
Population: Me

What if there's a bigger picture?
What if I'm missing out?
What if there's a greater purpose
I could be living right now
Outside my own little world

Stopped at a red light, looked out my window

I saw a cardboard sign, said "Help this homeless widow"

And just above that sign was the face of a human

I thought to myself, "God, what have I been doing?"

So I rolled down the window and I looked her in the eye

How many times have I just passed her by?

I gave her some money then I drove on through

And my own little world reached

Population: Two

For the majority of people in this
country, the first verse is something unimaginable. I’m sure it’s uncommon for
a child here to have a life free of worry. Considering the number of children I
see every day walking around the streets trying to sell random trinkets (seriously...you name it, they have it...you could do all your shopping from the car if you wanted to) or
bread or whatever to people driving by, I am quite certain that their
childhoods have not been the carefree experience that mine was. If you have a
roof over your head, access to clean water, more than one pair of shoes and if the
thought of getting excited to get a $0.50 tip seems crazy to you then you’re
probably more well off than you realize. I can’t even count the number of
people who have told me they are proud of me for coming here, as if coming here
was somehow more admirable than simply working in the US. I'm certainly proud to be part of this response effort, but dealing with
an emergency situation and realizing just how inadequate you are will knock
anyone down a peg or two. What I really like about this song is that it shows
that you can be part of a greater purpose wherever you are. I know it sounds cliché, but you can make a difference wherever you are. That helps me to remember that my small little piece can actually help make a difference in ending this outbreak and I'm honored to have the opportunity to work with so many amazing people committed to the same cause.

One other thing I’ve realized is that when I get home, there will be
ZERO people in my life that actually understand exactly what it has been like
to be here. I'm not trying to guilt trip anyone and I’m not upset by the fact that nobody understands how difficult
things have been for me. That’s completely irrelevant because no matter how
difficult or stressful my time here has been, pretty much everyone else in this country has
it far worse simply by virtue of where they were born. I’m upset (or maybe just saddened) because most people will never have experiences
like this. Not even just in terms of being part of the Ebola response, but in terms of experiencing life
in Africa or the developing world in general. They’ll never drive from Makeni to Kabala and watch naked
children with bellies bloated from malnutrition lounging around in the dirt, lethargic in
the brutal afternoon heat. They’ll never see children no more than 8 or 9 years
old stand outside on the street all day trying to sell food or random goods for
literally CENTS to help support their families. They’ll never spend a Sierra
Leonean rainy season living in a sturdy 3 bedroom house with tile floors and
air conditioning while just outside their gated compound people live in houses
with tin roofs and bamboo stick or mud walls that must be grossly unhelpful
when there’s a serious storm. And on top of all that, there's an Ebola outbreak. I feel totally inadequate to describe it to
anyone and, worse yet, I’m not sure anyone who hasn't been here would truly understand even if I explained it in the best prose ever written. It really bothers me that people just outside our compound are so poor and I'm living here with many of the same luxuries I have at home. I don't want to diminish the suffering of
people in the developed world. There are certainly struggles that everyone
faces and I know sometimes it’s fun to complain about first world problems and
completely idiotic things, but sometimes it just makes me angry. But I am just
as guilty as everyone else. I hope that when I come home something in me is
changed, but I know I’ll never be perfect. There will still be days when I’m
too lazy to get up and walk ten feet to get a drink of water from my
continuously flowing tap or when I get annoyed if the power is out for an hour
during a storm despite knowing that here in Sierra Leone people live year in
and year out with serious water restrictions at the end of the dry season and a
power supply that’s almost nonexistent for the majority of the year. Sometimes
I feel so guilty about it. I've been afraid that by being here everyday I'd become numb to the problems the people here face. Certainly some things that may have surprised me initially have become no big deal. For example, I'm no longer surprised when, despite the plethora of "No Urinating" signs, I see men urinating on the side of the road all around Freetown because they certainly don't have indoor plumbing in their homes and in a crowded city there aren't many places for latrines. I'm also no longer overwhelmed when a million people surround our car at Ebola checkpoints trying to sell their goods for a few cents or when soldier with very large guns that I'm not entirely convinced they know how to use safely, saunter up to our car trying to prove to us that they're in charge of all things Ebola related. These things don't even phase me. I was afraid that I would eventually feel the same way about the overwhelming poverty. While many of the signs of poverty that are all around me have become part of the background of my daily life, there's usually at least one thing everyday that reminds me just how lucky I am and that spurs me on to give everything I can to finish the job I came here to do.

Thursday, May 21, 2015

The
rainy season has officially begun in Freetown!! Before I get to that, let me
update you on some things that have happened since the last time I wrote. Almost
two weeks ago now, I went with Sasha and Meredith to Zsolt’s house to watch the
guys attempt to make mango brandy. Zsolt had been fermenting his mangoes for
more than a week and when we got there he had already started. I absolutely
despised chemistry when I took it, both in high school and the four ridiculous
semesters I was forced to take in college, but when I saw this machine set up
and different distillation fractions, I started geeking out a little bit. I
remembered how in orgo we had learned how wine and vodka and are made because it’s all chemical processes, ergo relevant to orgo. And let's be honest, there's probably nothing in the entire field of chemistry that's more interesting to a bunch of college kids than learning how to make alcohol. Anyway, I still
hate chem, but it was a lot of fun to watch the process, even though it was
pretty slow going. Ultimately, the mango brandy
was a bust as it apparently just turned to vinegar. There was a lengthy,
pseudo-scientific dinner discussion (interspersed with a brief, very random
conversation about the Great Schism and whether the guards gave Jesus water or
vinegar to drink when He was on the cross…) about why it had failed and the guys
decided to try again with other fruits like pineapple and, at my suggestion, watermelon.

﻿

Zsolt adding water...

I thought the coil was really cool

Sasha was really excited for his mango brandy

Look at those fractions!! SCIENCE.

The
next day we had a pretty lazy pool day. Early in the day, I watched random
Youtube videos about Turkey with Sasha and Meredith because Sasha was trying to
decide if he wanted to take a job in Antakya. He may also do a TDY there which
is a little funny because we think he wants a relaxing TDY, but Antakya, which
is very close to the Syrian border, is anything but relaxing right now thanks
to ISIS. Last Monday I went to dinner at Lagoonda with Nancy, Annisha and Amy
because it was Amy’s last night in Freetown. We ran into Sasha, Meredith, Zsolt
and one of their other friends there as well. The highlights of the evening
included Amy using “quagmire” in a sentence and being quite proud of it and, my
favorite quote of the evening (likely a quoteboard quote if the quoteboard was
still going), was when Amy, upon being asked if she wanted to go to the Radisson for dessert, said, “It’s a Monday! Let’s live it up in Freetown!
One gin and tonic AND dessert!” Clearly, Freetown is not the most happening place in the world right now.

Last
Tuesday morning we learned that the Swiss Ambassador would be coming the next
day. The compound we stay is for the Swiss government and the ambassador just
happens to stay in our apartment, specifically my bedroom, when he visits so we
had to move out for this guy’s Wednesday-Sunday visit. I was pretty annoyed
about this for several reasons. First, why couldn’t the ambassador just stay
somewhere else for the few nights he’s here? Second, if I’m being forced out of
my apartment, it would have been nice to have a little more warning than 24
hours. What naïve little me didn’t realize was that the Swiss pay for the
apartment year round, not just when the ambassador comes, so Rudy, the (sneaky
German) property manager, is secretly making extra money off of us when the
ambassador is away. When I first heard that the ambassador was coming I assumed
I could just take my clothes and anything that would be in his way out and
leave things like my wall calendar and food. WRONG. We had to make it look like
nobody else had been living there at all. The whole thing is ridiculous and to
make matters worse, I’m not sure our CR knows what’s going on. When I told him
we were being forced out for a few days he said, “Oh. That’s not right. Rudy
should have the ambassador stay somewhere else.” Face palm. Anyway, one good
thing did come out of it. I got to move to the third bedroom at Sasha and
Meredith’s and Nancy went to a different apartment so my stress level decreased
significantly. However, it's now been more than a week since we were forced out and we've discovered that the ambassador still hasn't even arrived. Who knows if or when he's even coming.

Last
Wednesday night, I went to Martin’s house (Martin is a Toyota dealer here and
we get a lot of our cars from him) for the weekly Wednesday night dinner. I’ve
been trying to go for ages, but I’m usually in the field so this was the first
time I was actually able to go. It was a blast. I got to watch the RM vs.
Juventus match, we ate delicious food (bruschetta, meatballs, stuffed peppers and more),
listened to some great music, stood on the porch so that the mist, which was
being blown at us like it was coming from a mister in Disney, would hit us when
it started to rain (we hadn’t had running water in a while so we all felt
pretty gross) and just hung out. I've never seen more people in one kitchen in my entire life. It was really funny to watch a bunch of European guys get so into cooking this meal for everyone. We also had a bit of a dance party because Martin has a machine that flashes cool lights across the room in tune with the music. We didn’t get home until about 1:30am so that
was a little late for me (because I’m an old person) and I was so tired for the
next couple of days, but it was a lot of fun. I hope to go again soon because the theme next week is Pizza Night. Everyone will be given dough and will get to make their own personal pizza and, despite the fact that I don't particularly enjoy cooking, I am PUMPED for this pizza night.

This dinner was serious business

On
Friday Francisco came to Sasha's and we spent the evening eating, listening to
music and just hanging out on Sasha’s veranda per usual. It was a fun night. We
talked about what’s become lovingly known as “The Yugoslav Mafia” which is
comprised of Sasha and his group of Eastern European friends here. It’s so
random that there are so many of them here in Freetown, but we’ve agreed that
if he can say my name is “Corleone” and that we just changed it when we arrived
in America because we didn’t want anyone to know we’re in the mafia (I promise we’re
not!), then we can say he’s part of the Yugoslav Mafia. We also discussed the
rain a bit and Francisco said it makes him think of the quote from “Forrest
Gump” when he’s in Vietnam and says,“One day it started raining,
and it didn't quit for four months. We been through every kind of rain there
is. Little bitty stingin' rain... and big ol' fat rain. Rain that flew in
sideways. And sometimes rain even seemed to come straight up from underneath.
Shoot, it even rained at night...” We’re not quite at that point yet here, but
it has started raining a lot more and hopefully we'll be at that point soon. It’s so fantastic. Apart from crisp, cool, sunny fall days, rainy days are my absolute favorite. The rain is so loud
because all the roofs are metal. It’s deafening sometimes. It typically rains
overnight, but Monday was the first day that it was still raining when we left
for work. It was so cool out and Nancy said that once the rainy season really
kicks in, it will be like that for good. Apparently we can go for weeks without
seeing the sun which makes me super excited because no sun means no heat which means
no grumpy, tired Nicole. Yay!! I'm just so much more energized when it's rainy. I didn't even have the air on in the office on Monday because it was so cool. Normally I drag my feet the whole way from the car, up all the steps and into my office, but I had such a spring in my step thanks to the rain on Monday. I'm really going to enjoy these next couple of months. And another added perk of the rainy season
picking up is that, because Freetown is mainly on hydroelectric power, we are
on city power a lot more so we don’t have the ridiculously loud generator on in
the background all the time at the compound. Also, this is totally random, but one day when we were driving home a traffic cop hit a guy driving a motorbike on the head with a stick. It was done playfully because the driver was trying to sneak through even though the cop had told him to stop. It was pretty funny. In the US someone would probably claim it was police brutality or something stupid like that. But here everyone was just laughing and kept driving without any semblance of order, as usual. There are no real traffic rules here and motorbikes get away with everything. They even drive on the wrong side of the road. So I guess the cop decided she was justified in giving this driver a playful little tap on the head and I loved everything about it. Here's one more random bit of info. There is a school right down the road from our office and when we drive by in the morning I always think of LSA because there are cars lined up, blocking traffic and dropping kids off and, apart from the fact that it's on a dirt road and there's trash and stray dogs everywhere, it's basically just like being on Smith St. around 8am on a school day. Anyway, last weekend was pretty lazy. Oh, except I graduated on Saturday!! I wasn't there, obviously, but it made me so happy to see everyone's picture and how happy they were. I'm lucky to have met so many amazing people during my time at BUSPH. It was a great experience and was obviously the right place for me. Now I'm officially Nicole M. Carloni MS, MPH. And I'm already thinking about what other letters I want after my name in the future. Anyway, Sasha and Meredith left on Sunday.
Sasha is on R&R in the south of France where he is visiting his son, Alex,
who’s at a tennis academy there. Meredith is in Massachusetts. It’s so
upsetting. It’s not necessarily that I was to leave here. It’s more just that
she gets to be there and I don’t. So now I’m staying at Sasha’s house by myself
which is pretty nice. I do miss the both of them though and I hope Sasha
decides not to go on TDY to Turkey because I want to have someone with whom I
can watch the French Open!! Anyway, this is a long enough post and nothing much
has really happened this week anyway other than me analyzing burial data
literally nonstop at the office every single day. We haven’t had a single day
with zero cases since the end of our eight days Ebola free which ended last
week. In fact, cases have quadrupled (from 2 new cases two weeks ago to 8 new cases last week) as the rains have started and that is not a good sign. It’s very depressing. In order for Sierra Leone to be declared Ebola free
by the time I leave, they have to have the first of 42 days with no new cases
by June 20th at the absolute latest. If Day 1 is on June 20th, Day 42 will be on August 2nd, the day I leave. June 20th is only a month away though and I'm getting nervous that it won't happen.

Monday, May 11, 2015

Last weekend (I guess it’s actually two
weekends ago at this point because I never got a chance to post this…) was
quite enjoyable. On May 2nd I hit the halfway point of my time here in Sierra
Leone!! Everyone has been in a pretty miserable mood lately so initially I was
upset at the thought of having to be here for another three full months, but
today I realized that in three months I’ll have to leave and that made me
sadder that I thought it would. It’s crazy to see how things have changed since
I arrived. When I first got here there were almost 100 new Ebola cases per week and
now we’re down to about 10 per week. It’s been such a stressful three months,
but I know this is exactly where I’m supposed to be. It might be hard right
now, but I know a lot of good will come out of it, hopefully both in terms of
personal growth and for the people who I’m able to help while I’m here. Anyway,
Saturday was a lot of fun. I spent a good amount of time swimming and sitting
out by the pool. Matthew, a CONCERN employee from the other compound, came over
at one point while I was outside and we chatted for a bit. He informed me of
the real reason that we haven’t had running water. Apparently every year around
this time the Giba Valley (or something like that) reservoir dries up. This year it happened
earlier than expected and it’s drier than usual so the government has started
rationing water. We’ve been getting pretty intense rainstorms (so intense that
I’ve had to remind myself that God promised never to destroy the world by flood
again and have then gone on to wonder if that promise extended to monsoons with
raging winds) most nights now that we’re on the brink of the rainy season, but
because it takes a long time for the reservoir to fill up we may see water
rationing even in the middle of the rainy season. Matthew pointed out that
rioting would be out of control if Freetown ran out of water and it would be
crazy if the “Ebola riots” that everyone expected actually had nothing to do
with Ebola, but were about water. It’s crazy that we have the ocean right next
to us and a bunch of rivers and it’s raining a lot and there’s still no running
water. Sometimes, if I'm sitting on Sasha's veranda on the weekend, I can hear people suddenly cheering as if Sierra Leone had just won the world cup. They're actually cheering because someone discovered running water. Anyway, later in the day on Saturday I played tennis with Sewah and
Meredith. Sewah is a semi-professional tennis player who trains Sasha and
Meredith. It was a lot of fun, but I have never been more hot, sweaty or
physically drained in my entire life. I was literally melting after just a few
minutes and felt like I could barely move my arms or legs. A tennis raquet has
never felt heavier. Davor made spaghetti
carbonara for us for dinner that night and it was delightful! On Sunday, I was
planning on sleeping super late since I was so tired from tennis the day
before, but around 10:30am I heard a knock on our door. Nancy answered it, but
I was too curious to stay in bed when I heard multiple people come up the
stairs. Turns out it was Annisha and Amy! Annisha had just gotten back from
R&R in London and Amsterdam so it was great to see her! Eventually Annisha
and I made our way over to Sasha’s and hung out there. Amy, Nancy and Davor
went for a work lunch at Country Lodge and Annisha, Ahmed (Annisha’s
boyfriend), Meredith, Sasha and I had lunch on Sasha’s veranda. Sasha, Meredith and I have also started watching an amazing show
called Orphan Black. Meredith has already seen it, but the third season just
started so Sasha and I are catching up before we watch it. Literally we spent
three nights in a row watching 3-4 hours of this show each night. So good. Check it out.

The view from Sasha's veranda

I was in the field for four days last
week (and yes, I was slightly distressed that I’d be missing Orphan Black
marathoning). That’s the longest I’ve been away from Freetown at one time and
it was exactly what I needed to pull me out of the miserable mood I’ve been in.
Things went well on the trip. Most importantly, Bombali hit 42 days with no new cases!! We walked into the Command Center that morning to find a sign on our office door congratulating the district. Everyone who walked into the office that morning had a smile on their face!! If the festive mood in the air was any indication, I can't wait for the joy and celebration that will come when the entire country hits 42 days!! Anyway, on my trip I visited Makeni, Kabala and Port Loko to get
stuff sorted out with our burial data. We’ve done about 7000 burials, but we
currently only have about 1000 records uploaded to a database being managed by
the Red Cross. The plan was to have the burial teams upload their data directly
onto an app on the smart phones we provided them, but that has turned out to be
a disaster. They either claim that they don’t have phone credit so they can’t
send the data (this is code for “We got the phone credit, but we used it to
make personal phone calls”) or that the app is malfunctioning which actually is
a real problem that’s been happening constantly. MHealth isn’t always the
wonderful solution that we want it to be. So we’re ditching the phones and I
now have the task of sorting through all the daily burial updates that are sent
to us to see what’s made it into the Red Cross database and what hasn’t and to
create our own Excel database of all 7000 burials (although I highly doubt I’ll
actually be able to find hard copies of the data I need for all of these
burials). Considering that some of the daily burial updates are in separate Word
documents rather than Excel spreadsheets and that there will be new burials
every single day, it’s going to be a tedious task. I could probably just assign
it to data people in each district, but then it would probably never get done.
It’s not that they wouldn’t do it. I’m sure they would postpone it for as long
as possible, but they would eventually do it. The issue is primarily that they
would be incredibly slow at doing it. I know that I need to be sensitive to the
fact that even most of the people we have hired specifically for data entry didn’t grow up
using computers. The same issue came up when they were entering data on the
phones. It took them about ten minutes to do something that would take me two minutes,
but I have to remember that they didn’t grow up texting. Sometimes I have just
wanted to grab the computer or phone from them and do it myself, but nobody is
going to learn that way and that’s not going to help this country in the long
run. So I just have to learn some patience. I think this entire six months is
pretty much an exercise in learning patience which is funny considering the
fact that I’m typically super patient in other areas of life. Long line at the
supermarket? No worries! I’ve arrived a little early and my room at the hotel
isn’t quite ready yet? No problem! But when it comes to technological
ineptitude or people who aren’t punctual, two things that are huge issues here,
I get frustrated very easily. Here’s hoping I’m a little better about these
things by the time I leave here.

CRS congratulating Bombali district on reaching 42 days Ebola free!!

When I was in Makeni I got sick. Like really, really sick. I rarely get sick and when I do, I'm not typically a whiny baby about it. I suck it up and deal with it. But this time was different. For the first time since I arrived, I experienced that terrifying moment when you wake up in the middle of the night, sweaty and violently ill, and as you sit there thinking about how you'd rather be dead and debating if you should wake someone up to take you to the hospital, your mind goes to that place...the place where, based on your symptoms and the fact that you're in a country with active ebola transmission, you have to seriously consider the (still unlikely) possibility that you have somehow become infected with Ebola. For the next two hours, between bouts of sickness and as I fought to remember everything else it was more likely to be other than Ebola, my two main thoughts were "Oh my gosh. I could actually die" and "Oh no! If I have Ebola I will have just ruined Bombali's Ebola free status!! Thankfully I'm doing just fine and it was probably nothing more than food poisoning. Anyway, when I was in Port Loko, I heard something very upsetting that, for some reason, my non-public health, non-medical, non-science colleagues don't seem to think is a big deal. Vaccines were being stored in Port Loko and 25,000 more are set to be stored there soon, but it turns out that there's not actually enough storage space. That's not the bad part. The bad part is that while vaccines were being stored there, the generator was being turned off at night. Now I don't know how long the vaccines would stay at the proper temperature with the generator turned off, but I'm thinking losing vaccine efficacy by not keeping them at the proper temperature is not a risk you want to take. But of course it's "a huge cost implication" if we have to start requiring them to leave the generator on so nobody wants to hear it. Utter nonsense. On Friday I drove back to Freetown. The trip to like 5 hours longer than it should have and I still wasn't feeling well so I wasn't thrilled at being stuffed in the car with 5-6 other people (and one live chicken that I'm sure was someone's dinner later that night). We had a car take us from Makeni to Masiaka and then had to wait over and hour in the intense heat for the car from Freetown that would take us the rest of the way back. On the plus side, there were some cute kids who wanted to be friends with me which is always fun. When we got back to Freetown, I found out that we were doing a poolside BBQ and that Sasha and Patrick would be playing some live music. There were a good amount of people there, but it was pretty low-key. I met a CAFOD employee who was working with CRS on the Turkey/Syria border before coming here. She had some pretty incredible stories. When her driver would take her home from the work site each night, she could look across the border into Syria and see a sea of black, ISIS flags. It was pretty amazing to hear some of her stories and I can't imagine how stressful that post must be.Lastly, in an effort to quell the wretchedly
miserable mood I and pretty much everyone else in this country program has been
in lately, I’ve started listening to this song a lot. It’s a good one and it's a good reminder when just about every day at the office or in the field seems like an insurmountable obstacle.

P.S. Today (May 11th) is SIX STRAIGHT DAYS WITHOUT A NEW CASE!!!! If you can't tell, I am really excited :-)﻿